1. Field of the Invention
The present disclosure medical procedures. More particularly, the disclosure relates to setting tissue anchors for tissue approximation and retraction in medical procedures.
2. Description of Related Art
During medical procedures on tissues surfaces, it is often desirable to pull tissue portions toward each other, generally known as “approximation”. For example, the tissue portions can be adjacent to a wound that needs suturing or other closure. The gap between adjacent sides of the wound may be so large as to make the closure tenuous and time consuming. Other medical procedures often benefit from pulling tissue portions away from each other, known as “retraction.” The tissue surfaces may benefit from such retraction for medical diagnosis, enhanced viewing and placement during surgical removal, and other medical procedures.
Known medical instruments, such as surgical hemostats and dressing forceps are routinely used for such procedures external to a body of an organism. However, the current endoscopic, laparoscopic, and other medical procedures performed internally to the body create an order of magnitude in complexity. The limited viewing and access during these internal procedures typically prohibit the use of such known instruments for tissue approximation and retraction. The size of the typical instruments is prohibitive for the internal procedures, but more importantly most procedures need to be done with one instrument inserted into the area.
When closing a gap after an excision or created by a wound, an internally inserted and actuated surgical clip can close a relatively small gap through its known mechanisms by the same instrument inserted into the area. However, a gap that exceeds the capabilities of the clips needs special and time consuming efforts to close. One known method is to start at one end of the gap and slowly close small sections progressively to the other end of the gap with a large number of clips, similar to the operation of a zipper. One recent procedure required about five hours to excise and close a 5 cm tumor.
To approximate large gaps in tissues or retract the tissues often requires inserting an anchor through the wall of the body portion, such as an abdominal wall, where a line, such as a suture, is attached to the anchor. The line can be pulled toward another anchor and line in another portion of the tissue to approximate the respective tissue portions, or toward another portion of the body to retract the tissue portion with the anchor away from an adjacent tissue portion. A needle with an anchor is used to push through the wall and locate the anchor on a distal side of the wall. However, inserting the anchor through the wall can be technically challenging due to the thickness of some portions of the wall. A significant amount of force is needed to push the needle and anchor through the wall and often bends the flexible endoscope or other scope through which the needle is inserted. The amount of force complicates the procedure and at time requires placement of the anchor to a less desirable location.
Thus, there remains a need for an improved method and device to insert an anchor into a tissue portion to approximate and retract the tissue portion.